Device configuration for supporting a patient oxygenation test

ABSTRACT

A physiological monitor device includes a central processing unit (CPU) that is configured to control operation of the device, a display screen, and one or more computer readable data storage media storing software instructions that, when executed by the CPU, cause the device to: create or modify a patient profile, select a patient test, store one or more test parameters selected or entered for the patient test, store one or more thresholds selected or entered for at least one of the test parameters, store one or more instructions for the patient, start the test, display test results while the test is in progress, determine whether any of the test parameters exceed limits set by the one or more thresholds, take one or more actions when it is determined that one or more of the test parameters exceed the limits set by the one or more thresholds, provide a summary and analysis of the test results, and send the test results to a computing device.

RELATED APPLICATION

This patent application is a divisional application of, and claimspriority and benefit to, co-pending U.S. patent application Ser. No.13/109,434 filed on May 17, 2011, and entitled “Device Configuration forSupporting a Patient Oxygenation Test”. All of the aforementionedpatent(s) and patent application(s) are herein incorporated by referencein their entirety.

BACKGROUND

Physicians are often faced with determining whether a patient has arespiratory condition that requires the use of supplemental oxygen. Forexample, a patient with a history of respiratory problems may appearconfused or manifest symptoms of lack of oxygen. However, adetermination of whether or not a patient needs supplemental oxygen isoften difficult to make. Clinical signs such as mental status, pulserate and breathing pattern are often unreliable indicators as to whetheror not supplemental oxygen is needed.

In practice, physicians often perform one or more oxygenation tests on apatient in which the patient may be asked to ambulate, typically bywalking, while the patient's oxygenation status is determined. However,methods used to determine the oxygenation status of a patient are oftenbased on the individual preferences and intuitions of a physician,rather than based on a standard workflow for determining oxygenationstatus.

SUMMARY

Embodiments of the disclosure are directed to systems and methods forperforming a patient oxygenation test using one or more computingdevices. In one aspect, an entry or selection of the patient oxygenationtest is received on one of the computing devices. The patientoxygenation test comprises a plurality of instructions for implementinga workflow for determining an oxygenation status for a patient. On oneof the computing devices, an entry or selection is received of one ormore physiological parameters for the patient to be monitored during thepatient oxygenation test. On one of the computing devices, an entry orselection is received of one or more thresholds for at least one of thephysiological parameters to be monitored during the patient oxygenationtest. On one of the computing devices, a determination is made as towhether any of the physiological parameters exceed limits set by the oneor more thresholds. On one of the computing devices, one or more actionsare taken when one or more of the physiological parameters exceed thelimits set by the one or more thresholds. On one of the computingdevices, a summary and analysis are provided of the test results.

The details of one or more techniques are set forth in the accompanyingdrawings and the description below. Other features, objects, andadvantages of these techniques will be apparent from the description,drawings, and claims.

DESCRIPTION OF THE DRAWINGS

FIG. 1 shows an example system, including a physiological measuringplatform (PMP) device, in which a patient oxygenation test may beconducted.

FIG. 2 shows an example PMP device that can be used in the examplesystem of FIG. 1.

FIG. 3 shows an example patient profile screen that can be used with thePMP device of FIG. 1.

FIG. 4 shows an example test parameters screen that can be used with thePMP device of FIG. 1.

FIG. 5 shows an example thresholds screen that can be used with the PMPdevice of FIG. 1.

FIG. 6 shows an example suggested tests screen that can be used with thePMP device of FIG. 1.

FIG. 7 shows an example monitoring screen that is displayed on the PMPdevice of FIG. 1 when a patient oxygenation test is in progress.

FIG. 8 shows an example test results summary screen that can be usedwith the PMP device of FIG. 1.

FIG. 9 shows an example test results analysis screen that can be usedwith the PMP device of FIG. 1.

FIG. 10 shows an example risk assessment screen that can be used withthe PMP computing device of FIG. 1.

FIG. 11 shows an example risk reporting screen that can be used with thePMP device of FIG. 1.

FIG. 12 shows a flow chart of a method for implementing a workflow for apatient oxygenation test.

FIG. 13 shows example components of the PMP device of FIG. 1.

DETAILED DESCRIPTION

The present disclosure is directed to systems and methods for providinga customizable workflow for the implementation of a patient oxygenationtest. The patient oxygenation test permits a physician to determine anoxygenation status for a patient and helps the physician determinewhether supplementary oxygen should be prescribed for the patient. Theworkflow determines how the test is conducted, determines parametersmonitored during the test and determines how test results are analyzedand presented to the patient.

The test is customizable to permit the physician to adjust the test tothe needs of the patient. The test can be saved so that trends may beidentified and to facilitate retesting. For example, the test may berepeated directly after treatment of the patient (pre and post treatmentand marking). The test typically requires a degree of ambulation toincrease the respiration and heart rate of the patient and determine thepatient's response to the increased heart rate and increasedrespiration. However, some patients with respiratory problems are oldand frail and may not be able to ambulate for as far or as long as otherpatients. In addition, some patients are overweight, out of shape andmay have physical and or mental conditions that limit an amount ofphysical activity that may be prescribed. For these reasons, a patientmay need to be stabilized before starting the test. Stabilization mayinclude one or more of checking a patient's vital signs before the test,having a patient rest and relax before the test and rechecking thepatient's vital signs periodically to ensure that the vital signs arewithin acceptable limits.

In examples, the patient oxygenation test may include one or moreindividual tests. For example, a physician may prescribe a series oftests in which the level of physical activity of the patient isgradually increased. For example, in one test the physician may firstask the patient to stand. In another test, the physician may ask thepatient to walk a short distance. In a third test, the physician may askthe patient to walk a longer distance. In this disclosure, the patientoxygenation test may refer to one test or to a series of tests.

FIG. 1 shows an example system 100 in which a patient oxygenation testmay be conducted. The example system 100 includes an examplephysiological measuring platform (PMP) device 102, a patient 104 and anexample results computing device 106. In this disclosure, a PMP deviceis a computing device on which a workflow is setup and on which thepatient oxygenation test may be monitored. In examples, the PMP device102 may be a patient monitor, for example the Connex® Vital SignsMonitor from Welch Allyn, Inc. of Skaneateles Falls, N.Y. In otherexamples, separate computing devices may be used to setup a workflow forthe patient oxygenation test and monitor the patient during the patientoxygenation test. For example, a portable device such as an iPad may beused to setup the workflow for the patient oxygenation test, a small orpatient wearable acquisition device may be used to monitor the patientduring the patient oxygenation test and a server computer may be usedfor analysis and reports generation of the results of the patientoxygenation test. Other examples of using separate computing devices arepossible.

In this disclosure, a workflow refers a set of activities, instructions,configured parameters, etc. used during the patient oxygenation test.The activities and instructions comprise one or more tests that comprisethe patient oxygenation test. During the one or more tests, theconfigured parameters are monitored and recorded on the PMP device 102.

The results computing device 106 is a computing device on which theresults of the patient oxygenation test may be viewed and analyzed. Inexamples, the results computing device 106 and the PMP device 102 may bethe same device. In other examples, the results computing device 106 maybe a different device than the PMP device 102.

FIG. 2 shows a drawing of an example PMP device 200. As shown in FIG. 2,vital signs of a patient, such as non-invasive blood pressure (NIBP),pulse rate, temperature and oxygen saturation (SPO2) may be measured anddisplayed on the PMP device 102. In addition, controls 218 permit aworkflow to be configured on the PMP device 200.

FIG. 3 shows an example patient profile screen 300 that can be used witha PMP device, for example with PMP device 102, to establish a profilefor a patient. The example patient profile screen 300 includes touchscreen buttons 302-310 on the bottom of the PMP device 102 and touchscreen buttons 312-322 on the top of the PMP device 102. In examples,more or fewer buttons may be used and the touch screen buttons 302-322may have a different functionality. In operation of the PMP device 102,names and functionality for touch screen buttons may change fordifferent screen views.

The example touch screen buttons on the bottom of the PMP device 102include a general button 302, a data management button 304, a networkbutton 306, a service button 308 and an oxygenation workflow button 310.The general button 302, data management button 304, network button 306and service button 308 are used for general setup, data management,network configuration and service for the PMP device 102. The exampleoxygenation workflow button 310 is used during setup, monitoring andresults analysis and reporting for the patient oxygenation test.

When the workflow button 310 is selected, the example touch screenbuttons 312-322 are displayed. The touch screen buttons 312-322 includea patient profile button 312, a test parameters button 314, a thresholdsbutton 316, a suggested tests button 318, a test results button 320 anda reporting button 322. The patient profile button 312 is used toestablish a profile for the patient. The test parameters button 314 isused to select and set one or more physiological parameters used in thepatient oxygenation test. The thresholds button 316 is used to setthresholds for one or more of the parameters used in the patientoxygenation test. The suggested tests button 318 is used to enter orselect and configure one or more tests that comprise the patientoxygenation test. The test results button 320 is used to provide asummary and analysis for the patient oxygenation test. The reportingbutton 322 is used to select results from the patient oxygenation testto be reported to the patient and physician. The reporting button 322 isalso used to select how and where the test results are displayed andstored.

As shown in the example patient profile screen 300 in FIG. 3, theoxygenation workflow button 310 is selected. The selection of theoxygenation workflow button 310 causes the buttons 312-322 to bepresented at the top of the user interface screen 300. When the patientprofile button 312 is selected, a patient profile screen 300, as shownin FIG. 3 is displayed.

The example patient profile screen 300 includes a text box 324 forentering or selecting the patient's name, a text box 326 for entering orselecting an identification number for the patient and a text box 328for entering or selecting the age of the patient. In examples, the textboxes 324, 326 and 328 may comprise edit boxes, pull-down list boxes ofany other type of data entry/data selection user interface component.

The patient profile screen 300 also includes example user interfacecomponents for entering or selecting a smoker status, drinker status andfamily history status for the patient. The smoker status box 330indicates whether the patient smokes tobacco products, includingcigarettes, cigars, etc. The example smoker status box 330 may be acheckbox, a text box or other similar user interface component. Theexample smoker score box 332 permits a user to enter a number thatrepresents an extent of the tobacco use. For example, the extent of apatient's tobacco use may be indicated by a score from 1 to 9 where 9represents a heavy smoker, for example one or more packs per day, and 1represents a minimum amount of smoking, for example one cigarette amonth. In examples, the smoker score box 332 may be disabled when thesmoker status box 330 indicates that the patient is not a smoker.

The example drinker status box 334 indicates whether the patientconsumes alcoholic beverages. The drinker status box 334 may be acheckbox, a text box or other similar user interface component. Theexample drinker score box 336 permits a user to enter a number thatrepresents an extent of the alcohol use. For example, the extent of apatient's alcohol use may be indicated by a score from 1 to 9 where 9represents a heavy use of alcohol and 1 represents a minimal use ofalcohol. In examples, the drinker score box 336 may be disabled when thedrinker status box 334 indicates that the patient is not a drinker.

The example family history box 338 is a text box in which a user mayenter textual information describing relevant aspects of family historyfor the patient. Some example types of information that may be enteredinto the family history box 338 may include whether anyone in thepatient's immediate family (for example, mother, father, siblings) hadany history of respiratory problems, heart disease, stroke, etc.Information entered into the family history box 338 may be used todetermine an overall family health risk for the patient. The overallfamily health risk may be entered in the example family history scorebox 340. For example, the family history score may range from 1 to 99,where a score of 99 indicates a very high family risk, for example bothparents having serious respiratory or circulatory problems and dyingfrom these problems.

In addition, to smoker status, drinker status and family history status,one or more other types of patient status, not shown in FIG. 3, may beobtained. For example a status and score regarding an obesity level ofthe patient may be obtained.

The example overall patient score box 342 may represent an overallrespiratory system health risk for the patient. The overall patientscore box 342 may be determined from a combination of the smokerhistory, the drinker history and the family history of the patient. Inaddition, other factors, such as patient obesity, may be used todetermine the overall patient score 342. In some examples, a physicianor other medical personnel may calculate and enter the overall patientscore. In other examples, the overall patient score may be calculatedvia a computer algorithm on the PMP device 102.

FIG. 4 shows an example test parameters screen 400 that can be used withthe PMP device 102. The test parameters screen 400 is selected when theoxygenation workflow button 310 is selected and when the test parametersbutton 314 is selected. The test parameters screen 400 is used to enteror select physiological or other parameters used for the patientoxygenation test.

The example test parameters screen 400 includes text boxes for enteringtarget parameters for ambulation and heart rate during the patientoxygenation test. The text boxes may be any combination of edit boxes,pull-down list boxes or other similar user interface components. Thetarget ambulation time text box 402 permits the user to enter a time,typically in minutes, during which the patient is ambulated during thepatient oxygenation test. Ambulation may include any combination ofwalking, running, standing and going up and down stairs.

In examples, a user may prefer to specify ambulation targets in terms ofdistance and pace. The target ambulation distance box 408 permits theuser to enter a distance for which a user should ambulate. For example,the distance may correspond to a number of walking paces. The targetambulation pace box 410 permits the user to enter a walking pace for thepatient, for example, slow, medium or fast.

The target heart rate box text box 404 permits the user to enter atarget heart rate for the patient during the patient oxygenation test.The target heart rate represents a desired heart rate for the patientduring the test. Typically, the patient starts off slow and then, ifpossible, works up towards the target heart rate. In examples, thetarget heart rate text box 404 may permit the user to enter a range forthe target heart rate. The target period for sustaining the target heartrate box 406 permits the user to enter a period of time, typically inminutes, for which the target heart rate entered in the target heartrate box 406 should be sustained.

The example test parameters screen 400 also permits the user to enter orselect vital signs for the patient to be monitored during the patientoxygenation test, giving the user the ability to customize the vitalsigns being monitored during the patient oxygenation test. In examples,the test parameters screen may include a blood pressure checkbox 412, anSPO2 checkbox 414, a respiration rate checkbox 416, a heart ratecheckbox 418 and a temperature checkbox 420. When a checkbox is checkedby the user, the corresponding parameter is monitored during the patientoxygenation test. More, fewer or different checkboxes may be used, eachcheckbox corresponding to a parameter to be monitored.

FIG. 5 shows an example thresholds screen 500 that can be used with thePMP device 102. The thresholds screen 500 is selected when theoxygenation workflow button 310 is selected and when the thresholdsbutton 316 is selected. The thresholds screen 500 is used to enter orselect thresholds for one or more of the test parameters entered orselected for the patient oxygenation test.

The example thresholds screen 500 includes text boxes for entering orselecting maximum thresholds for heart rate, respiration rate SPO2,systolic blood pressure and diastolic blood pressure. The examplethresholds screen includes a maximum heart rate text box 502, a maximumrespiration box 504, a maximum SPO2 box 506, a maximum systolic pressurebox 508 and a maximum diastolic pressure box 510. Each test box maycomprise an edit box, a pull-down list box or other similar userinterface component. More, fewer or different thresholds may be entered.

FIG. 6 shows an example suggested tests screen 600 that can be used withthe PMP device 102. The suggested tests screen 600 is selected when theoxygenation workflow button 310 is selected and when the suggested testsbutton 318 is selected. The suggested tests screen 600 is used to enteror select one or more tests that comprise the patient oxygenation test.

A suggested test is typically a series of instructions for the patient.For example, one test may instruct the patient to stand, walk to a dooror a wall in a room and then walk back. Another example test mayinstruct the patient to stand, walk down a corridor, turn left, walkdown a second corridor and return. Various combinations of instructionsare possible. The instructions may be graphical, auditory or textual.The series of instructions may also include a pace at which a patient isto walk, for example slow, medium or fast. The instructions may alsosuggest parameters to monitor, for example, heart rate, and bloodpressure. The suggested tests may be designated by level of difficulty,for example, easy, moderate or more difficult. One or more suggestedtests may be saved for recall to be used at a later test date. Inaddition, one or more suggested tests may be used as a template to beused for other patients. A physician or heath care person may select oneor more tests to include in the patient oxygenation test.

The example suggested tests screen 600 permits the selection of up tofour suggested tests. More or fewer suggested tests may be displayed.Example test 1 is selected by checking example checkbox 602 that isassociated with test 1. In examples, when checkbox 602 is checked, theuser is permitted to enter test information for test 1.

Test information for test 1 may be entered in example text box 604 or byselecting pre-configured test information. Pre-configured testinformation for test 1 may be selected via pull-down list box 608. Whenpull-down list box 608 is selected, the user may view a plurality ofavailable tests and select one test from this list. When a test isselected, a description of the test, including instructions for thepatient is populated in text box 604. In some examples, once selected,the user may be able to modify the instructions displayed. For example,the user may wish to modify the instructions to correspond to the roomor building that that patient is in, for example walk down a specifichallway or walk a specific number of paces. In other examples, onceselected, the instructions may not be modified.

In a similar manner, tests 2, 3 and 4 are selected by checkingcheckboxes 610, 616 and 622, respectively. Test information for tests 2,3, and 4 is entered or selected via test boxes 612, 618 and 624,respectively and via pull-down list boxes 614, 620 and 626 respectively.

After test information is entered, the patient oxygenation test may bestarted by pressing or selecting the example start testing button 628.When the start testing button 628 is pressed or selected, the PMP device102 begins monitoring data from the patient.

FIG. 7 shows an example monitoring screen 700 that is displayed on thePMP device 102 when the patient oxygenation test is in progress. Theexample monitoring screen 700 has a banner 702 that displays the name ofthe specific oxygenation test in progress, in this case oxygenationtest 1. A text box 704 displays the remaining time in oxygenationtest 1. A stop testing button 706 can be used to stop the test inprogress any time before the remaining time for the test has elapsed.When the time for the test elapses, the test automatically stops.

The example monitoring screen 700 also displays a current value forparameters being monitored by the test. In addition, for each parameterbeing monitored, a display indicator provides a visible alert when athreshold for the parameter is exceeded. The alert may also be anaudible alert. For example, display area 708 provides a current valuefor the blood pressure of the patient. A display indicator 710 providesa visible alert when the blood pressure exceeds a configured threshold.The thresholds for systolic and diastolic blood pressure are entered viathe example thresholds monitoring screen 500.

Similarly, display area 714 displays the current heart rate of thepatient and display indicator 716 provides a visible alert when theheart rate of the patient exceeds a configured threshold. Display area718 displays the current SPO2 oxygen saturation of the patient anddisplay indicator 720 provides a visible alert when the SPO2 levelexceeds a configured threshold. Display area 722 displays the currentrespiration rate of the patient and display indicator 724 provides avisible alert when the respiration rate exceeds a configured threshold.In examples, the monitoring screen 700 may include more or fewer displayareas and may include displays for different parameters.

The patient monitoring screen 700 also includes a patient identifier726. The patient identifier displays an identification number for thepatient and may also display the name of the patient. The patientmonitoring screen 700 also includes the oxygenation workflow button 310.In examples, when the patient oxygenation test in progress is completedor is stopped, pressing the oxygenation workflow button 310 returns thePMP device 102 to a previous screen, in this case displaying thesuggested tests screen 600. In examples, when returning to the suggestedtests screen 600 another suggested test may be selected and started. Inother examples, when more than one test is selected, a dialog box may bedisplayed when one of the tests is completed. The dialog box informs theuser that the test is completed. The dialog box may also prompt the userto start another test.

Inputs for the monitoring screen 700 are obtained via sensing devicesused by the patient and connected either directly or via wireless meansto the computing workflow device 102. As stated earlier, the PMP device102 may be a patient monitoring device, a vital signs monitoring deviceor similar type of device. For the case of blood pressure, the patienttypically wears a cuff on one arm with a physical connection, typicallya hose, to the PMP device 102. For SPO2, the patient typically wears asensor that clips onto a finger of the patient's hand and is alsoconnected to the PMP device 102. The PMP device 102 calculates SPO2using pulse oximetry. Other sensing devices are used for heart rate andrespiration.

Because some patients may be negatively affected by viewing test resultsduring the patient oxygenation test, it is possible for test data toaffect the results of the patient oxygenation test. For example, apatient may react negatively, raising the patient's heart rate forexample, when seeing a high blood pressure reading. For this reason, themonitoring screen 700 may be blanked during the patient oxygenationtest. In examples, when the monitoring screen 700 is blanked during thepatient oxygenation test, the suggested test screens 600, showinginstructions for the patient, may be displayed to the patient during thepatient oxygenation test.

It is also possible to adjust test parameters during the patientoxygenation test when one or more parameters for the patient exceedpredetermined values. For example, if a threshold for blood pressure,heart rate, respiration rate, etc, is reached or exceeded during thetest, it is possible to stop the test and adjust one or more of thesetest parameters to correspond to a lower stress level for the patient.

FIG. 8 shows an example test results summary screen 800 that can be usedwith the PMP device 102. In examples a separate results computingdevice, for example the results computing device 106 may be used insteadof the PMP device 102. In other examples, the PMP device 102 and theresults computing device 106 may be the same physical device.

The test results summary screen 800 is selected when the oxygenationworkflow button 310 is selected, when the test results button 320 isselected and when the summary button 804 is selected. The test resultssummary screen 800 provides a summary of the results of the patientoxygenation test.

The test results summary screen 800 includes a display area 812 thatdisplays a summary of test results for the patient oxygenation test. Thedisplay area 812 indicates a test name 814 for which results aredisplayed. In addition, the test duration 816, the measured bloodpressure 818 and the measured heart rate 820 are displayed. For themeasured blood pressure 818, average, low and high values are displayed.Average, low and high values are also displayed for the measured heartrate. A scroll bar 822 is provided to scroll down display other summaryresults for the patient oxygenation test. In addition, a back button 810is provided for returning to a previous screen. In examples, theprevious screen is a screen that preceded the display of the test resultsummary screen 800. For example, the suggested test screen 600 may bedisplayed when the back button 810 is pressed.

FIG. 9 shows an example test results analysis screen 900 that can beused with the PMP device 102. The test results analysis screen 900 isselected when the oxygenation workflow button 310 is selected, when thetest results button 320 is selected and when the analysis button 806 isselected. The test results analysis screen 900 provides means to analyzethe results of the patient oxygenation test.

The example test results analysis screen 900 permits the user to reviewmeasured results for any parameter monitored during the patientoxygenation test, to compare the results of parameters monitored withpast baselines, to view graphs that display the results of the monitoredparameters over time and to view graphs that display comparisons of theresults monitored with past baselines. The past baselines may includeprevious test results for the patient, test results for one or moreparameters based on guidelines for healthy patients test results for oneor more parameters based on guidelines for patients with respiratoryproblems. The guidelines for healthy patients and for patients withrespiratory problems may also be categorized by patient age. Otherbaselines and other means for analysis are possible.

The example test results analysis screen 900 includes an example selecttest text box 902. The select test text box 902 permits the user toenter the name of a performed test or to select a performed test from apull-down mechanism 904. Once a test is selected or entered, one or moreparameters that were monitored by the test may be individually selectedvia the example select parameter text box 906. A parameter may bemanually entered into the select parameter text box 906 or a monitoredparameter may be selected from a pull-down mechanism 908. When aparameter is entered or selected, one or more values for the monitoredparameter are displayed in a results parameter text box 914. Inexamples, an average value of the monitored parameter may be displayed.In other examples, a high value and a low value for the monitoredparameter may be displayed. In still other examples, a high value, a lowvalue and an average for the monitored parameter may be displayed. Ascroll bar 916 is provided to view the displayed results when more thanone value is displayed.

The example test results analysis screen 900 includes a graph checkbox918. When the graph checkbox is checked, a graph is displayed showingthe monitored parameter over time during the test.

The test results analysis screen 900 also includes an example selectcomparison text box 910. The select comparison text box 910 permits theuser to enter or select a parameter corresponding to an average or abaseline for the entered or selected parameter for one or morepopulation groups. For example, one parameter may correspond to measuredheart rate for healthy patients of one or more age groups. Anotherparameter may correspond to measured heart rate for patients with knownrespiratory problems for one or more age groups. A third parameter maycorrespond to measured heart rate for the current patient for patientoxygenation tests taken on one or more previous dates. The selectcomparison text box 910 includes a pull-down list box 912 that providesa pull-down menu of available parameters from which to select.

When a parameter is entered or selected in the select comparison textbox 910, data corresponding to the parameter is displayed in anassociated results parameter text box 920. In examples one or more of anaverage value of the parameter, a high value of the parameter and a lowvalue of the parameter are displayed in the results parameter list box920. A scroll bar 922 is provided to view the displayed results whenmore than one value is displayed.

The test results analysis screen 900 also includes a graph check box 924associated with the select comparison text box 910. When the graph checkbox 924 is selected, a graph is displayed showing a comparison of datafrom the parameter selected in the select parameter checkbox 906 withdata from the parameter selected in the select comparison text box 910.In this manner, the user can graphically visually the patient'smonitored data against one or more baselines.

The test results analysis screen 900 also provides a back button 810 forreturning to a previous screen. In examples, the previous screen is ascreen that preceded the display of the test results series of screens.For example, the suggested test screen 600 may be displayed when theback button 810 is pressed.

FIG. 10 shows an example risk assessment screen 1000 that can be usedwith the PMP device 102. The risk assessment screen 1000 is selectedwhen the oxygenation workflow button 310 is selected, when the testresults button 320 is selected and when the risk assessment button 808is selected. The risk assessment screen 1000 provides a health riskscore and health risk summary for the patient. The health risk score andhealth risk summary are based on the patient's health profile and dataobtained from the patient oxygenation test.

The risk assessment screen 1000 includes a patient risk score text box1002 and a health risk summary text box 1004. A patient risk scorerepresents a respiratory health risk for the patient. In examples, thepatient risk score is determined automatically by one or more softwarealgorithms on the PMP device 102. The one or more software algorithmsevaluate data from the patient oxygenation test in relation to thepatient's profile and in relation to data from one or more baselines.The data from the one or more baselines may include patient oxygenationtest data from healthy patients, from patients with respiratory problemsand from the patient's previous patient oxygenation tests. In addition,other baselines may be used. The patient risk score may also be based onan evaluation provided by the patient's physician.

The health risk summary text box 1004 permits the physician or othermedical personnel to manually enter a health risk assessment for thepatient. The health risk assessment may include any comments thephysician has regarding the results of the patient oxygenation test andthe health risk of the patient in the opinion of the physician. Thephysician may also use the health risk summary text box to determine apatient risk score and the physician may manually enter the patient riskscore in the patient risk score text box 1002.

The test results risk assessment screen 1000 also provides a back button810 for returning to a previous screen. In examples, the previous screenis a screen that preceded the display of the test results series ofscreens. For example, the suggested test screen 600 may be displayedwhen the back button 810 is pressed.

FIG. 11 shows an example reporting screen 1100 that can be used with thePMP device 102. The reporting screen 1100 is selected when theoxygenation workflow button 310 is selected and when the reportingbutton 320 is selected. The reporting screen 1100 is used to reportresults associated with the patient oxygenation test. A results summaryor detailed results may be reported. In examples, the results summary ordetailed results may be played back, sent to an electronic medicalrecords system or printed.

The example reporting screen 1100 includes a results summary checkbox1102 and a detailed results checkbox 1104. When the results summary 1102checkbox is checked, a results summary is reported. When the detailedresults checkbox 1104 is checked, detailed results are reported. Thedetailed results may identify specific ambulation points correspondingto specific test results. In addition, it may be possible to trend testparameters to a specific patient activity during the test. The examplereporting screen 1100 also includes a playback results button 1106, asend results to EMR button 1108 and a print button 1110. In examples,other buttons using different functionality may be provided.

When the playback results button 1106 is pressed, the patientoxygenation test may be played back on the PMP device 102. The playbackmay be in the form of a video showing the parameters monitored duringthe test over the time period of the test. For example, display boxesshowing remaining time, non-invasive blood pressure, heart rate, SPO2,respiration, etc., similar to display boxes 704, 708, 714, 718 and 722from the patient monitoring screen 700, may be provided. Other forms ofplayback are possible.

When the send results EMR button 1108 is pressed, the selected resultsof the patient oxygenation test are sent to an electronics medicalrecords database system for storage. When the print button 1110 ispressed, the selected results are printed.

FIG. 12 shows a flow chart of a method 1200 for implementing a workflowfor a patient oxygenation test. At operation 1202, a patient profile iscreated on a PMP device, for example a patient monitor or a vital signsmonitor similar to PMP device 102. If the patient profile alreadyexists, at operation 1202, the patient profile is edited. The patientprofile includes the name, age and patient identification number of thepatient. The patient profile also typically includes a medical profileof the patient including a smoker status, a drinker status and a familyhistory. The patient profile may also include a smoker score, a drinkerscore and a family history score. The patient profile is saved and isrecallable. The smoker score represents a degree to which the patient isa smoker, the drinker score represents a degree to which a patient is adrinker and the family history score represents an overall health riskfor the patient based on family history. The family history scoreincludes such factors as whether one or more parents or siblings had ahistory of certain health conditions, such as high blood pressure, heartdisease and respiratory problems, etc. The smoker score, drinker scoreand family history scores are numerical values, typically in the rangefrom 1 to 9 or 1 to 99, although other ranges may be used.

At operation 1204, a patient oxygenation test is entered or selected onthe PMP device. Typically, the patient oxygenation test is selected froma menu of patient oxygenation tests made available on a user interfacescreen, for example screen 600, of the PMP device. However, a specifictest may be manually entered by a user, typically a physician. Thepatient oxygenation test describes the test and typically includesinstructions for the patient. Example instructions are stand up, walkdown the hall, turn-around and come back, etc. In examples, the patientoxygenation test may comprise a plurality of tests, each test beingentered or selected via the user interface screen.

At operation 1206, a user of the PMP device, typically a physician orother medical staff, may enter specific instructions for the patient.Because the instructions available for the test may be general, the usermay want to personalize the instructions for the patient or for thefacility in which the test is conducted.

At operation 1208, one or more parameters are entered or selected forthe patient oxygenation test. The parameters represent patient vitalsigns that are to be monitored during the test. Some parameters that maybe entered or selected for the patient oxygenation test are bloodpressure, heart rate, SPO2 and respiration rate.

At operation 1210, one or more thresholds are entered or selected forthe one or more parameters entered or selected at operation 1208. Forexample a threshold may be entered for a maximum systolic bloodpressure, a maximum diastolic blood pressure, a maximum heart rate, amaximum SPO2, etc. Other thresholds may be entered, including minimumthresholds.

At operation 1212, the patient oxygenation test is started. The patientoxygenation test is typically started by pressing a start testing orsimilarly named button on a user interface of the PMP device. Forexample, the start testing button 628 on screen 600 may be pressed. Whenthe start testing button 628 is pressed, a test entered or selected atoperation 1204 starts.

When a test starts, at operation 1214 a monitoring screen, for examplemonitoring screen 700, is displayed on the PMP device. The monitoringscreen provides a display of the parameters being measured during thetest.

At operation 1216, a determination is made as to whether any thresholdsare exceeded during the patient oxygenation test. When it is determinedat operation 1216 that one or more thresholds are exceeded, at operation1218 one or more actions are taken. The one or more actions typicallyinclude the PMP device providing a visual and/or audible alert. In someexamples, only an audible alert is provided. The visual alert mayinclude activating a threshold indicator on the PMP device or displayinga dialog box with an alert message. Other visual displays are possible.An example threshold indicator is threshold display 716, indicating thata maximum threshold for heart rate has been exceeded. Other actions thatmay be taken include stopping the test, instructing the patient to slowdown, etc.

At operation 1216, when a determination is made that no thresholds havebeen exceeded during the patient oxygenation test, the test proceedsuntil completed. At the test completion, at operation 1220 adetermination is made as to whether more tests are to be run.

More tests may be run if multiple tests were selected at operation 1204.When multiple tests are selected, at the completion of a test a dialogbox may be displayed indicating that the test has completed andprompting the user whether to start another test. In examples, when onlyone test is entered or selected at operation 1204, a remaining timecount of zero indicates when the test is completed. For example, whenremaining time display 704 reads zero, the test is completed.

When it is determined at operation 1220 that more tests are to be run,control passes back to operation 1204 and a new test is entered orselected. When it is determined at operation 1220 that no additionaltests are to be run, control passes to operation 1222. At operation1222, a summary and analysis of test results is provided. In someembodiments, operation 1222 which provides a summary and analysis oftest results, occurs before control passes back to operation 1204.

The summary and analysis of test results at operation 1222 is typicallyprovided at a results computing device, for example results computingdevice 106. The results computing device is typically a computing devicewith a connection to a computer network. In examples, the resultscomputing device 106 is the same device as the PMP device 102. Thesummary and analysis of test results includes the ability to view theresults of individual test parameters, of comparing the test resultswith one or more baselines, of displaying graphs showing test parametersover time and graphically showing a comparison of the test resultsagainst the one or more baselines.

At operation 1224, test results are reported. Test results may bereported in summary or detailed form. The test results are typicallyreported to an electronic medical records system. The test results mayalso be printed out. In addition, one or more tests may be played back.

With reference to FIG. 13, example components of a PMP device 102 areshown. The components of the PMP device 102 also apply to a resultscomputing device 106. The PMP device 102 can include input/outputdevices, a central processing unit (“CPU”), a data storage device, and anetwork device.

In a basic configuration, the PMP device 102 typically includes at leastone processing unit 1302 and system memory 1304. Depending on the exactconfiguration and type of computing device, the system memory 1304 maybe volatile (such as RAM), non-volatile (such as ROM, flash memory,etc.) or some combination of the two. System memory 1304 typicallyincludes an operating system 1306 suitable for controlling the operationof an automatic blood pressure machine. The system memory 1304 may alsoinclude one or more software applications 1308 and may include programdata.

The PMP device 102 may have additional features or functionality. Forexample, the PMP device 102 may also include computer readable media.Computer readable media can include both computer readable storage mediaand communication media.

Computer readable storage media is physical media, such as data storagedevices (removable and/or non-removable) including magnetic disks,optical disks, or tape. Such additional storage is illustrated in FIG.13 by removable storage 1310 and non-removable storage 1312. Computerreadable storage media may include volatile and nonvolatile, removableand non-removable media implemented in any method or technology forstorage of information, such as computer readable instructions, datastructures, program modules, or other data. Computer readable storagemedia can include, but is not limited to, RAM, ROM, EEPROM, flash memoryor other memory technology, CD-ROM, digital versatile disks (DVD) orother optical storage, magnetic cassettes, magnetic tape, magnetic diskstorage or other magnetic storage devices, or any other medium which canbe used to store the desired information and which can be accessed byPMP device 102. Any such computer readable storage media may be part ofthe PMP device 102.

The PMP device 102 may also contain communication connections 1318 thatallow the device to communicate with other computing devices 1320, suchas over a network in a distributed computing environment, for example,an intranet or the Internet. Communication connections 1318 are oneexample of communication media. Communication media may typically beembodied by computer readable instructions, data structures, programmodules, or other data in a modulated data signal, such as a carrierwave or other transport mechanism, and includes any information deliverymedia. The term “modulated data signal” means a signal that has one ormore of its characteristics set or changed in such a manner as to encodeinformation in the signal. By way of example, and not limitation,communication media includes wired media such as a wired network ordirect-wired connection, and wireless media such as acoustic, RF,infrared and other wireless media.

The various embodiments described above are provided by way ofillustration only and should not be construed to limiting. Variousmodifications and changes that may be made to the embodiments describedabove without departing from the true spirit and scope of thedisclosure.

What is claimed is:
 1. A physiological monitor device comprising: acentral processing unit (CPU) that is configured to control operation ofthe device; a display screen; and one or more computer readable datastorage media storing software instructions that, when executed by theCPU, cause the device to: create or modify a patient profile; select apatient oxygenation test from a plurality of available patient tests,the patient oxygenation test comprising a plurality of instructions forimplementing a workflow for determining an oxygenation status for apatient; store one or more test parameters selected or entered for thepatient oxygenation test; store one or more thresholds selected orentered for at least one of the test parameters; store one or moreinstructions for the patient, the instructions to be followed by thepatient during the patient oxygenation test; start the patientoxygenation test; display the instructions for the patient to performone or more physical activities involving ambulation according to theworkflow for determining the oxygenation status for the patient; displaytest results while the patient oxygenation test is in progress;determine whether any of the test parameters exceed limits set by theone or more thresholds; when it is determined that one or more of thetest parameters exceed the limits set by the one or more thresholds,take one or more actions; provide a summary and analysis of the testresults; and send the test results to a computing device.
 2. Thephysiological monitor device of claim 1, wherein store one or more testparameters comprises storing one or more of a time duration for test, adistance that the patient is required to walk during the test and awalking pace during an ambulation phase of the test.
 3. Thephysiological monitor device of claim 1, wherein provide an analysis andsummary of the test results further comprises providing a riskassessment that compares the patient to a healthy individual or to ahealthy population and providing a risk score for the patient based onthe test results.
 4. The physiological monitor device of claim 1,further comprising the computer readable data storage media encodingsoftware instructions that, when executed by the CPU, cause the deviceto provide an option for playback of the test results.